Sternal defect reconstruction using a double-barrel vascularized free fibula flap: a case report

• Main Authors: Paula Rocha Gravina, Daniel K. Chang, James A. Mentz, Rami Paul Dibbs, Marco Maricevich
• Format: Article
• Language: English
• Published: Korean Society of Plastic and Reconstructive Surgeons 2021-09-01
• Series: Archives of Plastic Surgery
• Subjects: sternal; reconstruction; fibula; bone; plastic
• Online Access: http://www.e-aps.org/upload/pdf/aps-2021-00682.pdf

Total and subtotal sternectomy oncological defects can result in large deficits in the chest wall, disrupting the biomechanics of respiration. Reviewing the current literature involving respiratory function and rib motion after sternectomy, autologous rigid reconstruction was determined to provide the optimal reconstructive option. We describe a novel technique for sternal defect reconstruction utilizing a double-barrel, longitudinally oriented, vascularized free fibula flap associated with rib titanium plates fixation. Our reconstructive approach was able to deliver a physiological reconstruction, providing rigid support and protection while allowing articulation with adjacent ribs and preservation of chest wall mechanics.